Stem Cells, Canadian Blood Services, Ottawa, ON K2E 8A6, Canada.
Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada.
Curr Oncol. 2023 Mar 22;30(3):3549-3556. doi: 10.3390/curroncol30030270.
The COVID-19 pandemic profoundly influenced unrelated donor (UD) allogeneic peripheral blood stem cell (PBSC) collections. Changes included efforts to minimize COVID-19 exposure to donors and cryopreservation of products. The extent to which the efficacy and safety of PBSC donations were affected by the pandemic is unknown.
Prospective cohort analysis of PBSC collections comparing pre-pandemic (01 April 2019-14 March 2020) and pandemic (15 March 2020-31 March 2022) eras.
Of a total of 291 PBSC collections, cryopreservation was undertaken in 71.4% of pandemic donations compared to 1.1% pre-pandemic. The mean requested CD34 cell dose/kg increased from 4.9 ± 0.2 × 10 pre-pandemic to 5.4 ± 0.1 × 10 during the pandemic. Despite this increased demand, the proportion of collections that met or exceeded the requested cell dose did not change, and the mean CD34 cell doses collected (8.9 ± 0.5 × 10 pre-pandemic vs. 9.7 ± 0.4 × 10 during the pandemic) remained above requested targets. Central-line placements were more frequent, and severe adverse events in donors increased during the pandemic.
Cryopreservation of UD PBSC products increased during the pandemic. In association with this, requested cell doses for PBSC collections increased. Collection targets were met or exceeded at the same frequency, signaling high donor and collection center commitment. This was at the expense of increased donor or product-related severe adverse events. We highlight the need for heightened vigilance about donor safety as demands on donors have increased since the pandemic.
COVID-19 大流行深刻地影响了无关供体(UD)异基因外周血造血干细胞(PBSC)采集。这些变化包括努力将 COVID-19 暴露风险降至最低以及对产品进行冷冻保存。大流行对 PBSC 捐献的疗效和安全性的影响程度尚不清楚。
对 PBSC 采集进行前瞻性队列分析,比较大流行前(2019 年 4 月 1 日-2020 年 3 月 14 日)和大流行期间(2020 年 3 月 15 日-2022 年 3 月 31 日)两个时期。
在总共 291 例 PBSC 采集中,大流行期间有 71.4%的采集进行了冷冻保存,而大流行前仅有 1.1%。请求的 CD34 细胞剂量/公斤平均值从大流行前的 4.9±0.2×10增加到大流行期间的 5.4±0.1×10。尽管需求增加,但满足或超过请求细胞剂量的采集比例没有变化,收集的平均 CD34 细胞剂量(大流行前为 8.9±0.5×10,大流行期间为 9.7±0.4×10)仍高于请求的目标。中心静脉置管的频率更高,大流行期间供体的严重不良事件增加。
大流行期间 UD PBSC 产品的冷冻保存增加。与此相关的是,PBSC 采集的请求细胞剂量增加。采集目标以相同的频率得到满足或超过,表明供体和采集中心的高度承诺。这是以增加供体或产品相关的严重不良事件为代价的。我们强调需要提高对供体安全的警惕性,因为自大流行以来,对供体的需求增加了。